Certified Medical Auditor Reimbursement Specialist
Go a step beyond certified coder! Receive national certification as a Medical Auditor / Reimbursement Specialist.

The CMARS combines the expertise of the certified coder and a financial analyst.
Course prerequisites are certification in the following disciplines:
An A.A. in a related field can be substituted for the applications certifications


This training prepares the participant for more analytical presentations. Transform yourself from support personnel into a key staff member involved in analysis and recommendations. Learn how to communicate what you know in a way that is vital for decision making. Executive management will use your presentations for meetings and discussions. Transform what you are already doing into a successful business tool.







WHAT IS A REIMBURSEMENT SPECIALIST?


A reimbursement specialist is a combination of medical coder and a financial analyst. The coding background allows the analysis to be done with more comprehension and recognition of impact.

This capacity also encompasses the skillset to analyze the billing process to determine appropriateness in payments. This analysis is made against contract review, chargemaster setup, pricing methodology, contract negotiation support, and market analysis.

Another function of a reimbursement specialist is the review of reimbursement tools of the practice. That is, review and update of all forms, primarily the superbills (charge tickets) within the electronic health record and the Advanced Beneficiary Notice (ABN) forms.


WHAT IS A MEDICAL AUDITOR ?


A medical auditor is a coder capable of reviewing medical documentation and the assigned procedure and diagnosis codes to determine if those code assignments are appropriate. This determination is based on ethical coding guidelines and the application of CMS/AMA/payer-specific Documentation Guidelines.

A medical auditor has the skillset to create an audit report to report findings to the provider/executive management. The findings are used as a basis for making recommendations to be implemented as improvements in the operation. This provides the organization with the tools to reduce their risk.


WHAT IS A MEDICAL AUDITOR REIMBURSEMENT SPECIALIST?


A medical auditor reimbursement specialist encompasses all skills in the above two categories. Additionally, this individual possesses the skills to communicate findings in a presentation style. Further, findings and their interpretation are made in well written reports with citations.

As a medical auditor reimbursement specialist one has the know-how and recognition to influence policy and thus impact an organization's navigation through the tumultuous healthcare changes making them manageable.





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